Pyogenic granuloma (PG) is a common benign vascular lesion characterized by an exuberant proliferation of granulation tissue in response to various stimuli, including trauma, chronic irritation, and hormonal influences. Despite its misleading name, PG is neither pyogenic nor granulomatous. It frequently affects the skin and mucous membranes, with the oral cavity being a common site of occurrence. Oral PGs present diverse clinical features that may mimic more serious pathologies, making accurate diagnosis essential for effective management. The etiology of PG is multifactorial, with trauma, poor oral hygiene, dental plaque, calculus, and hormonal changes—particularly during pregnancy—playing significant roles. These factors provoke an exaggerated localized connective tissue response, resulting in a rapidly growing, erythematous, and often bleeding mass. Clinically, PG may appear as a pedunculated or sessile lesion, typically smooth or lobulated, and prone to surface ulceration upon trauma. The gingiva is the most frequently affected site, accounting for approximately 75% of oral cases, though lesions can also occur on the lips, tongue, buccal mucosa, and palate. PG predominantly affects young individuals, with a peak incidence in the second decade of life, and shows a higher prevalence among females, likely due to hormonal influences. Given its benign nature, PG generally responds well to conservative surgical excision, with excellent clinical outcomes. This study reviews the clinical variants and surgical outcomes of oral pyogenic granulomas in patients treated at Korle Bu Teaching Hospital, Accra, Ghana. Understanding the clinical spectrum and optimal management approaches for PG is critical for improving patient outcomes and minimizing recurrence.